Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Wound Care |
163WW0000X | |||
Primary Care |
363LP2300X | 50 | Nurse Practitioner |
| NPI # | 1649881434 |
| LBN Legal business name | DR JOSE A RIVERA LLC |
| Authorized official | JOSE RIVERA - (PRESIDENT) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 08/14/2020 |
| Last updated | 05/14/2026 - About 3 weeks ago |
| Identifiers | n/a |
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DR JOSE A RIVERA LLC
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